aggression replacement training (art) for … replacement training (art) for reducing antisocial...

Aggression Replacement Training (ART) for reducing antisocial behaviour in adolescents and adults.

C. Kaunitz, A.K. Andershed, L. Brännström, & G. Smedslund

PROTOCOL Approval date: 4 November 2010 Publication date:

2 The Campbell Collaboration | www.campbellcollaboration.org

Contact reviewer Catrine Kaunitz Department of Knowledge Based Policy and Guidance National board of Health and Welfare 106 30 Stockholm Sweden +46 75 247 37 66 [email protected] Contribution of reviewers Internal sources of support None

mailto:[email protected]


Table of contents

TABLE OF CONTENTS 3

1 BACKGROUND 4

1.1 Description of the condition 4

1.2 Description of the intervention 4

1.3 How the intervention might work 6

1.4 Why it is important to do this review 7

2 OBJECTIVE OF THE REVIEW 9

3 METHODS 10

3.1 Criteria for considering studies for this review 10

3.2 Search methods for identification of studies 11

3.3 Data collection and analysis 13

3.4 Data synthesis 18

4 REFERENCES 20

4.1 references 20

5 TABLES 25

6 SOURCES OF SUPPORT 28

6.1 Internal sources 28

6.2 External sources 28


1 Background

1.1 DESCRIPTION OF THE CONDITION

Antisocial behaviour manifests itself in many different forms. A broad definition

encompasses all actions that deviate significantly from established social norms. The

type of behaviours included in this definition (e.g., substance abuse, theft,

aggression) varies between countries (and many other terms are often used

(offender, conduct disorder, delinquency) for the same behavior. Consequently there

is no common metric to measure and synthesize prevalence and incidence of

antisocial behavior.

Several approaches have been used to treat youth and adults with antisocial

behaviour. Previous systematic reviews including meta-analyses suggest that

cognitive-behavioral interventions (CBT) are among the more promising

rehabilitative treatments for antisocial behaviour in youths (Lipsey et al 2001;

Landenberger & Lipsey 2005; Armelius & Andreassen 2007). Within this approach,

a number of prevention programmes have been developed to prevent and treat

antisocial behaviour. Different cognitive-behavioral approaches have also been

found to reduce recidivism with adult violent offenders, but rehabilitation programs

for adults are still novel, and few published studies examine the recidivism outcomes

of those who take part in such programs (Polaschek & Collie, 2004). Much attention

has been paid to the importance of self-control in regulating antisocial, delinquent

and criminal behavior and there have been several efforts to create techniques and

programmes to improve self-control among particularly children and adolescents

(Piquero et al 2010). Aggression Replacement Training (ART) is an example of such

a programme.

1.2 DESCRIPTION OF THE INTERVENTION


The ART-method is a multimodal programme originally developed for aggressive

delinquents in residential care in New York, USA. It is a structured programme that

combines the use of techniques from cognitive therapy (based on cognitive theories)

and behavioral therapy (from learning theory). The main components include anger

management, development of social skills and moral reasoning. According to the

original manual (Goldstein, Glick & Rainer 1987) ART is a 10-week, 30 –hour

intervention, administered to groups of 8-12 youths three times a week. According to

the developers (Goldstein et al 1987), aggression has an affective component, a

behavioral component and a values component. Thus, ART came to consist of

skillstreaming to teach prosocial behaviour (behavioral component), anger control

(affective component), and moral reasoning (cognitive component). It is an

educational and training approach to replace the antisocial behavior by actively

teaching the desirable behaviours (Goldstein et al 1987). Goldstein and his colleges

encouraged the extension and modification of the program to new settings, client

groups and outcomes (Goldstein et al 2004).The programme is now available in

more or less revised forms for other forms of antisocial behaviour and populations

for example adult violent offenders. The programme was for example selected for

national implementation in English and Welsh probation service and progressed

through their offending behaviour programme accreditation prior to

implementation (Lipton et al 2000). The programme has also been implemented

and accredited in the Swedish prison and probation service (Kriminalvarden.

Retrieved, October, 27, 2010. Available at;

2http://www.kriminalvarden.se/sv/Fangelse/Arbete-klientutbildning-och-

behandling/ART/).

Skillstreaming

The behavioral component of ART consists of social skills training, a technique for

teaching pro-social behaviour to participants who are weak or lacking these

competencies. The teaching of skills serves to displace the out of control destructive

behaviours with constructive prosocial behaviour. Theoretically the method is

founded in social learning theory and the work of Bandura (1973).

The manual provides a skill checklist of 50 desired skills to identify skills that the

participants are missing, which the program then should be focusing on. Flexibility

exists to substitute some skills for others according to needs. Each skill is broken

down into its behavioral components which are modelled by the trainers and role-

played by each trainee during the session. Some skills are complicated like

understanding other people‟s feelings, while others are less complicated like

preparing yourself for a difficult conversation (Goldstein et al., 1987).

Anger management


The anger control training component of ART is designed to help make the

arousal of anger in chronically aggressive persons less frequent and to provide

means to learn self-control when anger is aroused. Just as skillstreaming is designed

to teach what one should do in problematic situations, anger control training

teaches what one should not do. The anger control training has its foundation in the

early anger control work of Novaco (1975) and Meichenbaum (1977).

Anger control training is a multistep sequence in which trainees are first helped to

understand how they typically perceive and interpret the behaviour of others in ways

that arouse anger. Therefore, in the first lesson, attention is given to identify the

external and internal triggers that initiate the anger. The self-control sessions

identify triggers and likely consequences of anger and aggression. The self-

awareness of triggers and arousing feelings of anger is then used to develop

alternative prosocial strategies. The trainer demonstrates the proper use of anger

reduction techniques like deep breathing and backward counting,

Moral reasoning

Moral reasoning training is the third component in ART (Gibbs et al 1995). It has

its foundation in Kohlberg‟s (1973) model of moral development with the purpose to

raise the individual‟s level of moral reasoning in order to make more mature

decisions in social situations.

In ART moral reasoning is promoted in group discussions of moral dilemmas

(social decision making meetings). Basically the trainer presents a moral dilemma

where the participants can choose between different alternatives. The trainees

choose one position each, motivate individually and discuss with one another. The

manual provides ten problem situations designed to create opportunities for

participants to consider the perspectives of others.

1.3 HOW THE INTERVENTION MIGHT WORK

Goldstein and colleagues argued that aggressive behavior and other forms of

antisocial behaviour can be traced to three factors, general shortfall in pro-social

behaviour (personal, interpersonal and social-cognitive skills), and low level of

anger control and an immature, egocentric style of moral reasoning. The skill

streaming component of ART aims to develop social skills which form pro-social

behavior. This emotion-oriented section of the programme aims to equip the

individual with self-control to manage anger and aggression. The third component

of ART addresses the concrete and egocentric thinking typically seen in those who

display aggressive behaviour. The developers claim that these components together


provide a programme that will help the participants to function pro-socially

(Goldstein et al 1998).

1.4 WHY IT IS IMPORTANT TO DO THIS REVIEW

A number of outcome studies of Aggression Replacement Training have been

conducted in the US (Barnoski, 2004; Coleman et al 1992) and in Europe (Hatcher

et al 2008; Gundersen & Svartdal, 2006; Moynahan, 2005; Holmqvist et al 2005).

Several studies have indicated promising results for the method for example when it

comes to recidivism. An outcome evaluation from Washington State showed for

example that, when completely delivered, ART has positive outcomes with estimated

reductions in 18-month felony recidivism of 24 percent, compared to the control

group. Most of the studies were conducted by the programme developers (Goldstein

et al 1987; Goldstein et al 1994; Leeman et al 1993).

ART-trials have been included in meta-analytic reviews of effects of a wider array of

interventions with juvenile offenders (e.g., Lipsey & Derzon 1998; Armelius et al

2007). Most of them do not report separate results for ART and no review has

specifically addressed the programme. Lipsey et al (2007) do report separate results

for ART and according to the analysis ART shows positive effects compared to

control groups when it comes to recidivism (reported OR > 5). Two independent

studies are included. Results of ART outcome studies have also been summarized

in non-systematic reviews. Several reviewers suggested that ART is a promising

empirically-based treatment for juvenile offenders (Springer et al 2003; Loeber et al

1998). Other reviews conclude that ART is an effective programme (Sherman et al

2002; Cigno & Bourn 1998). The U. S Department of Justice claim in their model

program Guide that ART is an effective program (OJJDP Model programs Guide.

Retrieved, October 27, 2010. Available at http:// www.

ojjdp.gov/mpg/mpgProgramDetails.aspx?ID=292).

Aggression Replacement Training is one of the oldest prevention programmes. Since

the 1990s it has been provided across North America and Europe within a wide

variety of social, educational, correctional services, secure units, community services

and prisons. Teachers, counselors, youth care workers, social workers, and

correctional officers are examples of people who become trainers. There have been


claims for the effectiveness of the intervention but few studies of ART made by

independent researchers have been included in meta-analysis and reviews despite the fact

that test searches show that several studies made by independent researchers do exist. No

review includes ART for adults. Hence, a systematic review of ART as a separate

program should be an important issue of concern for researchers, policy and for

practice.


2 Objective of the review

To assess the impacts of ART in residential care and community settings for

reducing antisocial behaviour in young and adult people.


3 Methods

3.1 CRITERIA FOR CONSIDERING STUDIES FOR THIS

REVIEW

3.1.1 Types of studies

To be included studies should be experimental, where individuals or groups are

randomly assigned to conditions, or quasi-experimental with use of parallel cohorts.

Analysis of the absolute effects of ART will involve comparing ART to no treatment

and to untreated wait list controls. The relative effects of ART (versus other

interventions) will be conducted separately and will include studies that compare

ART to other interventions and/or Treatment-As-Usual (TAU). Studies that

compare ART with ART and additional components/treatment will be excluded. All

follow-up durations reported in the primary studies will be recorded. Both

standardized and unstandardized measures will be acceptable measures.

In order to assess whether the evaluator can be regarded as independent, internet

searches will be made for each author involved in the included study. An

independent evaluator cannot have vested interests in the intervention (e.g.

economic or psychological as a developer or program proponent). In other words,

the independent evaluator should be “…free of any real or perceived bias introduced

by receipt of any benefit in cash or kind, any hospitality, or any subsidy derived from

any source that may have or be perceived to have an interest in the outcome…”

(Higgins 2008, Box 2.6a).

3.1.2 Types if participants

Participants are males and females (12 years and older) with antisocial behaviour.

Both participants in residential care (including prison, secure and open settings) and

community settings will be included. Voluntary, mandated as well as sentenced

participants will be included.


3.1.3 Types of interventions

Since ART has no trademark, the practical application varies. For inclusion in the

review only studies that label the programme they are evaluating “Aggression

Replacement Training” (ART) is to be included. Further, the authors have to refer to

Goldstein and include a statement that the core principles in the programme are

being followed.

3.1.4 Types of outcomes

Primary outcomes

Any recidivism in antisocial behaviour (criminal behaviour, drug-use, school

attendance) that is measured in the studies will be considered.

Secondary outcomes

Other measures of behaviour (for example social skills, interpersonal skills and

anger management), cognition (e.g., moral reasoning) and psychiatric symptoms on

standardized tests, for example Social Skills Rating System (Gresham & Elliott

1990). Measures based on unstandardized tests will only be considered if

documented psychometric properties are reported.

Analyses will be made for different follow-up periods depending on available data;

immediately post-intervention, short-term (up to one year post-intervention and

long term (over one year post intervention).

3.2 SEARCH METHODS FOR IDENTIFICATION OF STUDIES

3.2.1 Search strategy

Searches will be conducted in electronic reference databases, government databanks

and professional websites. There are no restrictions regarding language or date of

publication. To identify unpublished reports and ongoing studies, ART- developers

and independent investigators will be contacted. Reference lists of included studies


and all reviews will be scanned for new leads. Once a final set of included documents

is defined, this list will be sent to lead authors of included studies, together with

inclusion criteria, in order to find out if any documents are missing, including grey

literature. Conference papers (at least as titles and abstracts) are crucial when

publication bias is to be assessed. The following reference databases will be

searched:

ASSIA

Cochrane (CDSR, DARE, TRIALS, HTA)

Campbell Library

Criminal Justice Abstracts

Proquest Dissertation & Thesis

ERIC

Pub Med

PsycINFO

Sociological Abstracts

Social Work Abstracts

Social Policy and Practice (which includes Social Care Online).

Additional searches will be made by means of Google and Google Scholar and going

through the first 100 or 200 hits.

Search strategies has been developed by using various terms for aggression

replacement, aggression control therapy, aggression prevention, positive peer

culture, equipping youth to help one another, EQUIP program, Prepare curriculum,

PEACE curriculum, Family ART, etc. We will also search for studies including

descriptors/keywords describing the three components of ART; the affective

component, the behavioral component and the values component. The synonyms

from the three categories will be combined with “OR” in every category and with

“AND” between categories (see Table 1 and 2 for examples of search syntaxes for

Pub Med and PsycInfo).

It must be emphasized that syntaxes will be modified and tailored for each database

and provider. Each tailored search will include controlled terms, terms from a

thesaurus or an index (depending on database and database provider), as well as


free-text terms. A set of articles, that needs to be visible, will be used in order to

validate each tailored search.

3.3 DATA COLLECTION AND ANALYSIS

3.3.1 Selection of studies

Two reviewers will independently screen titles and abstracts. Selection of primary

studies will be made according to criteria described above. Studies considered

eligible by at least one of the reviewers on the basis of titles and abstracts, will be

retrieved in full text. The full texts will then be appraised by two reviewers. The same

persons will decide whether the studies meet the inclusion criteria. Any

disagreements about eligibility will be resolved by the review team. Reasons for

exclusion will be documented for each study that is retrieved in full text.

More specifically, the selection process will have the following steps (the process will

be documented by means of EndNote software and finally stored in RevMan 5.0):

1. Pairs of reviewers will independently select potentially-eligible studies for full-text

retrieval on the basis of the inclusion criteria by considering the Title, Abstract, and

Subject Terms for each document. A study will be retrieved in full text if reviewers

disagree about its potential eligibility. The results will be stored in an EndNote

database “Abstract screening”.

2. Pairs of reviewers will independently read documents in full and decide to include or

exclude the document on the basis of the inclusion criteria. If reviewers disagree, a

third reviewer will have a decisive vote. Primary reasons for exclusion will be

documented. The results will be stored in a second EndNote database “Full text

inclusion - preliminary”.

3. The complete list of included documents will be sent to a selected group of external

international experts together with the inclusion criteria. These experts will be asked

whether they know of any eligible studies that are missing studies. They will also be

asked if they know of any reasons why any of the included studies should be

excluded. Finally they will be asked if they know of any other documents (published

or not) on the included studies that could be informative during step 4.

4. Any suggestions from the external international experts will be processed in

accordance with step 2 above. The results will be stored in a third EndNote database

“Full text inclusion - final”.


5. The final set of included documents will be studied in order to find multiple

publications from the same study and multiple studies in single publications. The

purpose is to select a set of unique studies. The problem of multiple publications

from single studies will be approached by looking at the site and time frame of the

evaluation, the intervention, the number of participants in experiment and control

groups respectively, etc. The results will be stored in a fourth EndNote database and

in RevMan 5.0 “Included unique studies”.

3.3.2 Data extraction and management

Guided by the checklist of items to consider in data collection and data extraction

detailed in the Cochrane Handbook (Higgins 2008, Table 7.3.a), at least two

independent coders will extract data and store the data in a table in Word-format

focusing on populations, interventions, comparisons, and outcomes as basic coding

categories (see Table 3). Differences in coding will be resolved by discussion and

when not possible a third author will be adjudicated. When necessary the

corresponding author of studies will be contacted.

3.3.3 Assessment of risk of bias in included studies

Methodological quality and risk of bias regarding included studies will be assessed

independently by at least two reviewers on the basis of the revised CONSORT

statement and checklist for randomized controlled trials (Altman 2001) and the

Cochrane Handbook (Higgins 2008, section 8). Included studies will be assessed

on adequate sequence generation, allocation concealment, outcome assessors,

incomplete outcome data, selective outcome reporting, and other sources of bias, in

a risk of bias table. In all cases, an answer „Yes‟ indicates a low risk of bias, and an

answer „No‟ indicates a high risk of bias. „Unclear‟ will indicate an unclear or

unknown risk of bias. Given the nature of the method it is unlikely that providers

and participants in the intervention can be blinded; quality of blinding will be

determined primarily by whether those who assessed and coded outcome measures

were blind to treatment conditions. Since studies using quasi-experimental methods

will be included information about baseline differences and attempts made to

control for them will be examined. Details of each study will be provided in

additional tables.


3.3.4 Measures of treatment effect

If means and standard deviations are available continuous data will be analyzed to

calculate effect size (e.g., from t-tests, or exact p-values). Hedges g will be used for

estimating standardized mean differences (SMD) where scales measure the same

clinical outcomes in different ways (e.g., psychiatric symptoms).

If there is a mix of studies with some reporting change scores and others reporting

final values, we will contact authors and request the final values. If we do not obtain

these values, we will analyze change scores and final values separately (Higgins

2008, chapter 9, section 9.4.5.2).

For dichotomous outcomes we will calculate risk ratios (Relative Risk) with 95 %

confidence intervals and p-values. In order to calculate a common metric odds-and

risk ratios will be converted to effect size (Chinn 2000). As pointed out in Higgins

(2008, section 9.6) there are statistical approaches available which will re-express

odds/risk ratios as standardized mean differences allowing dichotomous and

continuous data to be pooled together. Even if effect sizes cannot be pooled, study-

level effects will be reported in as much detail as possible. Software for statistical

analyses will be RevMan 5.0 and STATA 10.0.

3.3.5 Unit of analysis issues

The authors will take into account the unit of analysis of the trials to determine

whether individuals were randomized in groups (i.e. cluster randomized trials),

whether individuals may have undergone multiple interventions at once, whether

results were reported at multiple time points, and whether there were multiple

treatment groups. The robustness of transforming continuous and dichotomous

outcomes into a common metric will be assessed by analyzing each outcome

measure separately.

Cluster randomized trials

It is possible that participants will be randomized to groups in clusters, either when

data from multiple participants in a setting are included (creating a cluster within

the residential or community setting), or when participants are randomized by

treatment locality or clinic. For trials that use clustered randomization, results will

be presented with proper controls for clustering (robust standard errors or

hierarchical linear models). If appropriate controls are not used and it is impossible


to obtain the full set of individual participant data, the data will be controlled for

clustering using the procedures outlined in Higgins (2008). That is, when outcome

measures are dichotomous, the number of events and number of participants per

trial arm will be divided by the design effect [1 + (1 - m) * r], where m is the average

cluster size and r is the intra-cluster correlation coefficient (ICC). When outcome

measures are continuous, the number of participants per trial will be divided by the

design effect, while leaving the mean values unchanged. To determine the ICC, the

reviewers will use estimates in the primary trials on a study-by-study basis.

However, where these values are not reported, the reviewers will use external

estimates of the ICC that are appropriate to each trial context and average cluster

size by contacting the trial lists and if they are not available, the reviewers will seek

statistical assistance from the Cochrane/Campbell Methods Group (Higgins 2008).

Multiple interventions per individual

If the participants in some of the trials receive ART plus treatment as usual, those

studies will be meta-analyzed separately, with the ART plus treatment as usual arm

compared to treatment as usual alone. The discussion of those results will take into

account the additional treatments received.

Multiple time points

When the results are measured at multiple time points, each outcome at each time

point will be analyzed in a separate meta-analysis with other comparable studies

taking measures at a similar time point post-intervention. These will be grouped

together as follows: immediately post-intervention, short-term (up to one year post-

intervention and long term (over one year post intervention).

Studies with multiple treatment/control groups

For trials where there are multiple treatment/control groups, data from the same

group will not be analyzed twice. Thus, multiple contrasts from the same study will

not be pooled in the same meta-analysis.

The treatment condition will be selected for meta-analysis according to which ones

match the inclusion criteria. The comparison condition will be treatment-as-usual,

the least active treatment offered, or, if neither of those is an option, the condition

that is most focused on the participant in treatment sessions.

When there is more than one control group, we will do pair-wise comparisons. This

means that effects will be calculated on the basis the following types of comparisons:


A vs. B, A vs. C, and B vs. C. When A is a defined intervention and C is a no-

intervention or placebo-type of intervention, we will use the term “effect”. Yet if A is

a defined intervention and B also is a defined intervention, then we will use the term

“improved effect” in comparison to the control intervention. When “usual care” is a

sufficiently described intervention, we will use the term improved effect, and if

“usual care” means no intervention “effect” will be used. In cases when “usual care”

is not defined, additional information from the authors or other reliable sources will

be used.

3.3.6 Dealing with missing data and incomplete data

Missing data and dropouts will be assessed in the included studies. Reasons,

numbers, and characteristics of dropouts will be investigated and reported. Efforts

will be made to contact the authors when further information or data are necessary.

Any meta-analyses will use data from all original participants when possible, and

will report when that is not the case. For studies in which the missing data are not

available, a sensitivity analysis will be used to assess potential bias in the analysis

and the extent to which the results might be biased by missing data will be

discussed.

Although we will seek any important but unreported data from the authors of the

original studies, it is sound to assume that this approach is not always successful. As

a consequence of this, we will also consider utilizing the imputation methods

outlined in White & Higgins (2009).

3.3.7 Assessment of heterogeneity

Heterogeneity among included studies will be examined through the use of the 2-

test, where a low p-value (p<0.1) indicates heterogeneity of treatment effects. The I2

statistic will also be used to determine the percentage of variability that is due to

heterogeneity rather than sampling error or chance (Higgins 2008). The authors will

also consider issues such as design quality, publication bias, voluntary or mandatory

participation, and differences in participant‟s characteristics as possible reasons for

any heterogeneity and conduct sensitivity analyses accordingly, where data permit.

If heterogeneity is present we will investigate possible sources using the following

steps; subgroups analyses, meta-regression and sensitivity analyses.


3.3.8 Assessment of reporting biases

Funnel plots will be drawn to investigate any relationship between effect size and

standard error when possible. While the visual appraisal of funnel plots will assist us

in gaining an understanding of the nature of the data, it is also appropriate with a

less subjective appraisal of the evidence for funnel plot asymmetry (Sterne & Egger,

2005). As a consequence of this, we will run a number of statistical tests for funnel

plot asymmetry (e.g. Egger‟s linear regression method).

3.4 DATA SYNTHESIS

Meta-analysis will be used when event rates or means and standard deviations are

available or can be calculated and studies include similar populations (e.g. similar

age range, criminal history, setting, etc.), methodology (e.g. randomization,

measurements, time points, etc.), and outcome measurements. Thus, when

interventions, control groups, participants, and outcomes are sufficiently similar,

pooled effects will be calculated. In other cases, when these conditions are not met,

results will be shown but not pooled (Higgins 2008, section 16.5.4). When the 2-

test or the I2 statistic indicates heterogeneity, a random effects meta-analysis will be

used. Where studies appear to be homogeneous according to known characteristics

and those statistics, a fixed effects model will be used. When meta-analysis is

inappropriate, a narrative description of the study results alone will be provided,

although general conclusions about the effectiveness of ART would not be possible

in that case.

3.4.1 Subgroup analysis, moderator analysis and investigation of

heterogeneity

Subgroup analysis and investigation of heterogeneity

Subgroups analyses will be made of ART with different subpopulations which

include:

· Service setting (juvenile justice, prisons, and open care)

· Duration of observation period

· Counterfactual condition (“usual services”, other treatment)

· Older versus younger participants.

Since previous research indicate that studies conducted by program developers

produce significantly more positive results than those conducted by independent


researchers (Petrosino & Soydan, 2005; Shadish et al 2002) we will also analyze

independence from program developers. We will assess results from RCTs

separately from results of quasi-experimental studies and separate analyses will

examine studies that support intent-to-treat analysis. The analyses will be conducted

to study variations in effect sizes between studies.

3.4.2 Sensitivity analysis

In order to assess the robustness of the conclusions, sensitivity analyses will be

conducted to assess the impact of the quality of the included studies. The quality

criteria used in the analyses will be as described above. The analysis will include:

· Comparing results from studies with inconsistencies in the definition,

measurement, or reporting of results (e.g. differential attrition, dropouts, lack of

intention to treat analysis, outcome measures not taken at consistent time points for

all participants) with results from consistent studies.

· Most methods for dealing with missing outcome data requires detailed data

for each participant. Since only limited information is typically available in

published reports we will focus on the case of incomplete binary outcomes (White &

Higgins 2009)

· Reanalyzing the data using different statistical approaches (e.g. using a fixed

effects model instead of a random effects model (Higgins 2008) and multivariate

meta-analysis (White 2009).

· Independence from program developers will also be considered in the

analyses (Petrosino & Soydan, 2005; Shadish et al 2002).


4 References

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5 Tables

Table 1: Pubmed 100317, Aggression Replacement Training (ART)

Hanna Olofsson (information specialist) & Catrine Kaunitz (lead reviewer)

Nr Search terms Numbers of ref. **)

1. aggression replacement training[tiab] OR aggression replacement therapy[tiab] OR aggression replacement treatment[tiab]

2

2. Aggression control therapy[tiab] 1

3. aggression prevention[tiab] 9

4. Positive peer culture[tiab] OR equipping youths to help one another[tiab] OR equipping youth to help one another[tiab]

0

5. prepare curriculum[tiab] OR (PREPARE AND prosocial curriculum[tiab]) OR PEACE Curriculum[tiab] OR (PEACE[tiab] AND arthur Goldstein[tw]) OR (Family ART[tiab] AND Goldstein[tw])

1

6. 1 OR 2 OR 3 OR 4 OR 5 11

7. Social Behavior[MAJR] OR Social Skills Training[tiab] OR Prosocial Behavior[tiab] OR Social Skills Training[tiab] OR Social Skills[tiab] OR prosocial skills training[tiab] OR Skillstreaming[tiab] OR self-management training[tiab]

57740

8. Anger[MAJR] OR Aggression[MAJR] OR Behavior Control[MeSH] OR Anger Control[tiab] OR anger treatment[tiab] OR Self Control[tiab] OR Aggressive Behavior[tiab] OR Anger management[tiab] OR Aggression control[tiab] OR Self-regulation Skills[tiab]

29311

9. Moral Development[MeSH] OR Morals[MAJR] OR Moral education[tiab] OR moral reasoning[tiab] OR moral judgement[tiab]

14788

10. 7 AND 8 AND 9 35

11. 6 OR 10 46


Table 2: PsycInfo via EBSCO 100317

Agression replacement Training (ART)

Searches by Hanna Olofsson & Catrine Kaunitz

Söknr Termtyp *) Söktermer Antal ref. **)

1. TI TI "aggression replacement" or AB "aggression replacement" or SU "aggression replacement" or MJ "aggression replacement" or DE "aggression replacement" or KW "aggression replacement" or TX "aggression replacement" or TC "aggression replacement"

55

2. TI "aggression control therapy" or AB "aggression control therapy" or SU "aggression control therapy" or MJ "aggression control therapy" or DE "aggression control therapy" or KW "aggression control therapy" or TX "aggression control therapy" or TC "aggression control therapy"

5

3. TI "aggression prevention program*" or AB "aggression prevention program*" or SU "aggression prevention program*" or MJ "aggression prevention program*" or DE "aggression prevention program*" or KW "aggression prevention program*" or TX "aggression prevention program*" or TC "aggression prevention program*"

9

4. TX "Positive peer culture" OR AB "equipping youths to help one another" OR TI EQUIP OR AB "EQUIP program" OR AB "EQUIP programme"

46

5. 1 OR 2 OR 3 OR 4 112

6. DE ”Social Skills Training" OR DE "Prosocial Behavior" OR DE Social Skills Training OR DE ”Social Skills”

14492

7. prosocial skills training OR Skillstreaming 30

8. 6 OR 7 14501

9. DE "Anger Control" or DE "Self Control" OR DE Aggressive Behavior

22735

10. ”Anger management” OR ”Anger control strategies” OR ”Anger control training” OR ”Aggression control” OR ”Self-regulation Skills”

1077

11. 9 OR 10 23321

12. DE "Moral Development" 4856

13. "Moral education" OR "moral reasoning training" OR "moral judgement"

1268

14. 12 OR 13 5518

15. 8 AND 11 AND 14 16

16. 15 OR 5 124

*)


Table 3: Basic categories for extracting data

Study

identification

Reviewer notes Population Interventions Control Outcomes

1) Target

population

2) Eligibility

criteria

3) Sample

description

4) Timeframe

5) Context:

Local, State,

Country

6) Other

1) Intervention

ART

2) Control 1

Usual Care, Placebo, no

intervention, etc

3) Control 2


intervention, etc

4) Control n


intervention, etc

5) Other

1) Randomization

procedure

2) Intervention sample

(a) Original: N1=

(b) Final: n1=

(c) Attrition at follow up

3) Control sample

(a) Original: N2=

(b) Final: n2=

(c) Attrition at follow up

4) Blinded detection

5) Adherence

6) Intention-to-treat

analysis

7) Conflicts of interest

(authors)

8) Overall

methodological quality

9) Other

1) Results and

conclusion

Results favors…

2) Primary outcomes:

measures of recidivism in

antisocial behaviour

3) Data

(a) counts and proportions

(b) means and standard

deviations

4) Calculated effect

sizes

(a) Relative Risk

(b) SMD

5) Secondary

outcomes: other

measures of behavior (e.g.

anger management)

6) Secondary

outcomes: measures of

cognition

7) Secondary

outcomes: measures of

psychiatric outcomes

8) Other


6 Sources of support

6.1 INTERNAL SOURCES

None

6.2 EXTERNAL SOURCES

None

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